Operation for an intestinal obstruction due to volvulus in a 32 weeks pregnant lady!!
The image above shows a greatly dilated sigmoid colon that almost fills the entire abdomen! Intestinal obstruction due to sigmoid volvulus during pregnancy is rare. The presenting symptoms seen in these patients are the same as with non-pregnant patients - constipation, abdominal bloating, nausea and vomiting, with marked abdominal distention on examination. This condition occurs when the sigmoid colon twists around itself and its narrow and elongated mesentery and, not surprising, the obstruction of the intestinal lumen and impairment of vascular perfusion occur when the degree of torsion exceeds 180 and 360 degrees, respectively, leading to necrosis. Plain abdominal radiography showing the dilated loops often with a few air-fluid levels is used to diagnose the volvulus in most cases with CT scan or MRI as the confirmatory tests when necessary. Surgically, after the colon has been untwisted, resection of sigmoid colon and descending colon and primary anastomosis is performed. A nonresective alternatives is also widely used with mixed success. Rapid surgical involvement is mandatory to prevent complications such as hemorrhagic infarction, perforation, septic shock, and death.
We learn about it, but always hard to imagine how that could fit into a human body
